Citation

Owen GS, Szmukler G, Richardson G, David AS, Hayward P, Rucker J, Harding D, Hotopf M. Br. J. Psychiatry 2009; 195(3): 257-263.

Affiliation

Department of Psychological Medicine and Psychiatry, Institute of Psychiatry, King's College London, London SE5 9RJ, UK. g.owen@iop.kcl.ac.uk

Copyright

(Copyright © 2009, Royal College of Psychiatry)

DOI

10.1192/bjp.bp.108.059782

PMID

19721117

PMCID

PMC2802509

Abstract

BACKGROUND: In England and Wales mental health services need to take account of the Mental Capacity Act 2005 and the Mental Health Act 1983. The overlap between these two causes dilemmas for clinicians. AIMS: To describe the frequency and characteristics of patients who fall into two potentially anomalous groups: those who are not detained but lack mental capacity; and those who are detained but have mental capacity. METHOD: Cross-sectional study of 200 patients admitted to psychiatric wards. We assessed mental capacity using a semi-structured interview, the MacArthur Competence Assessment Tool for Treatment (MacCAT-T). RESULTS: Of the in-patient sample, 24% were informal but lacked capacity: these patients felt more coerced and had greater levels of treatment refusal than informal participants with capacity. People detained under the Mental Health Act with capacity comprised a small group (6%) that was hard to characterise. CONCLUSIONS: Our data suggest that psychiatrists in England and Wales need to take account of the Mental Capacity Act, and in particular best interests judgments and deprivation of liberty safeguards, more explicitly than is perhaps currently the case.

Language: en